EFFECTIVENESS OF A MULTIMODAL PATIENT EDUCATION PROGRAM IN PATIENTS WITH AND WITHOUT TROPHIC ULCERS OF THE LOWER EXTREMITIES ASSOCIATED WITH PERIPHERAL ARTERY DISEASE

Didar Khassenov, Bakhtiyar Serik, Samat Sagatovich Saparbayev, Султаналиев Т.А., Azat Chinaliyev, L. Arias, Roza K Suleimenova, Galiya Orazova

Actual Problems of Theoretical and Clinical Medicine, 2026

Полный текст Открытый доступ: Gold Метаданные (CSL-JSON)
DOI 10.64854/2790-1289-2026-52-2-03
Достоверность данных 70 средняя
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Аннотация

Relevance. Chronic limb-threatening ischemia is the most severe manifestation of peripheral artery disease, carrying high rates of amputation and mortality. Structured patient education programs have demonstrated benefit in other chronic diseases, yet remain largely unevaluated in peripheral artery disease, particularly chronic limb-threatening ischemia. Objective. To evaluate the effectiveness of a structured multimodal educational program (CLTI School) compared with standard care on clinical outcomes and quality of life in patients with peripheral artery disease. Materials and Methods. Parallel-group randomized controlled trial conducted in Astana, Kazakhstan. A total of 184 patients with peripheral artery disease (Rutherford categories 2-5) were randomized 1:1 and followed for 12 months. The program comprised eight vascular surgeon-led group sessions, a digital platform, peer support groups, and smoking cessation counseling. Per-protocol analysis included 81 experimental and 78 control participants. Co-primary outcomes were health-related quality of life (SF-12) and peripheral artery disease -related hospitalization rate. Results. At 12 months, the experimental group showed significantly higher SF-12 Physical Component Summary (44.76 vs. 35.08; p < 0.001) and Mental Component Summary (43.42 vs. 35.90; p < 0.001) scores. Hospitalizations (14.8 % vs. 20.5 %; p = 0.346) and amputations (4.9 % vs. 7.7 %; p = 0.476) were numerically lower but did not reach statistical significance. Smoking cessation was threefold higher (25.0 % vs. 8.5 %; p = 0.026), pain declined significantly (median VAS 3 vs. 5; p < 0.001), and QALYs were higher (0.67 vs. 0.60; p < 0.001). No adverse events attributable to the program were recorded. Conclusions. The Chronic limb-threatening ischemia School significantly improved patient-reported outcomes and smoking cessation in patients with peripheral artery disease. Structured educational programs should be considered an integral component of comprehensive peripheral artery disease management.